Utilization Review Specialist — Care Coordination
Acadia Healthcare
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Job summary
Sabal Palms Recovery Center in Brooksville, Florida is seeking a Full Time Utilization Review Specialist to monitor utilization of services and optimize reimbursement. The role supports the facility's treatment program for adults 18 and older.
Schedule: Monday–Friday, 40 hours weekly; pay starts at $20 and increases with experience. Responsibilities include liaising with managed care, performing reviews, tracking length of stay, and ensuring medical necessity and proper documentation.
Qualifications
- High school diploma or equivalent required.
- Clinical experience or 2+ years in healthcare utilization management preferred.
- Certification in CPR and de-escalation may be required.
Responsibilities
- Act as liaison between managed care organizations and facility staff.
- Conduct reviews of insurance plans for reimbursement requirements.
- Monitor length of stay and inform staff of issues affecting stays.
- Gather data and report utilization, discharges and quality of services.
- Conduct quality reviews for medical necessity and services.
- Facilitate peer review calls and manage admissions appeals.
- Assist admissions with pre-certifications and staff training on docs.
- Perform other duties as assigned.
Skills
Education
Job description
Sabal Palms Recovery Center in Brooksville, Florida is seeking a Full Time Utilization Review Specialist to monitor utilization of services and optimize reimbursement. The role supports the facility's treatment program for adults 18 and older.
Schedule: Monday–Friday, 40 hours weekly; pay starts at $20 and increases with experience. Responsibilities include liaising with managed care, performing reviews, tracking length of stay, and ensuring medical necessity and proper documentation.
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